Bariatric surgery is currently the most successful and safe procedure in the treatment of obesity accompanied by health problems such as diabetes, hypertension, cholesterol, gastric reflux, osteoarthritis or sleep apnea.
To guarantee that this surgery improves the patient's quality of life in a significant and permanent way, it is important to understand that it is not a cosmetic intervention, that it is not an emergency surgery and that a process must necessarily be followed.
After clarifying these ideas, Dr. Ramiro Guadalupe, an expert laparoscopic surgeon in obesity at the Metropolitan Hospital, explains what the steps are for safe bariatric surgery; Whether this is a gastric sleeve or a gastric bypass, they are two surgical options to combat obesity.
The first criterion that the specialist evaluates to give the green light to bariatric surgery is the patient's body mass index. It is a relationship between the person's weight in kilos and their height in meters. If this index ranges between 25 and 29.9, the diagnosis is overweight that can still be treated with a change in habits and does not require surgery.
From a body mass index of 30, the patient is considered obese and if, in addition, they present diseases derived from their obesity such as diabetes, hypertension, gastric reflux, sleep apnea, among the most common, they become a candidate for a bariatric surgery.
A patient who is already a candidate for bariatric surgery must commit to changing their lifestyle habits to ensure the success of the surgical intervention as they return to their normal life.
" If there is no commitment, and he is operated on, this patient will gain weight again and he will do so quickly, then he will not be satisfied. Surgery is part of a whole process. "
Dr. Ramiro Guadalupe, surgeon. An interdisciplinary group made up of an internist, a nutritionist, a psychologist and an endocrinologist (if necessary) must evaluate the patient to determine if he or she is fit for surgery, explains Dr. Guadalupe.
“We help the patient become the protagonist of this process; We have the obligation to give him the time he needs, before surgery, to learn to eat better, to exercise, to reduce his anxiety,” says the surgeon.
In selecting the most appropriate procedure for each patient, an endoscopy is essential, which rules out reflux problems and the analysis of the particularities of each person. If reflux is present, a gastric bypass is recommended, which reduces the size of the stomach and intestines to limit the absorption of food.
If the patient eats too much, a sleeve or reduction of stomach capacity may be sufficient. If the obese person has metabolic disorders or suffers from uncontrolled diabetes, the best surgery will be a gastric bypass because it attacks food absorption.
For a consecutive year, after undergoing bariatric surgery, the patient must attend permanent check-ups to act in time against a possible nutritional deficit and verify changes in habits.
Exercise and an adequate diet are key to preventing muscle loss or sarcopenia from occurring during weight loss. It is important to maintain psychological support for the patient to continue motivating them and control the anxiety that diet changes can cause.
When can bariatric surgery be unsafe?
Bariatric surgery that is carried out hastily, without following the aforementioned steps, can become unsafe for the patient, indicates Dr. Guadalupe. Care must also be taken in selecting the health center or medical unit that will be in charge of the operation.
“You should go to centers that are trained to treat obesity, where there is a multidisciplinary team and where the patient is correctly informed”; The surgeon also recommends “not getting carried away by social networks” to avoid bad decisions that put your health at risk.